After his cancer radiation sessions, Nirmal Bhartiya started experiencing severe back pain in 2014-15. That is when, after many visits to several doctors, someone referred him to a chiropractor based in Delhi’s Nizamuddin East. “Within two weeks, my back pain was almost gone,” said Bhartiya, 65, a businessman. The first session lasted about 10-15 minutes, and he could feel the difference. He has now taken it upon himself to refer patients with chronic issues that need spinal adjustments to Dr. Shiv Bajaj.
“Ninety percent of orthopedic condition should be treated conservatively; rarely you need surgeries. Surgeries should only be restricted to tumors, fractures, and the like. It should not happen on the basis of back and neck pain,” said Dr. Bajaj. While surgery has become commonplace in today’s medical field, chiropractic treatment administered at the right time by licensed and trained chiropractic professional can prevent medications and surgical interventions, and is the “missing link” between physiotherapy and orthopedics in India, Dr. Bajaj, who has been practicing for 11 years, said.
Rita Gupta, a 66-year-old housewife, who had severe sciatica pain — with her left leg experiencing numbness — agreed. “I was not able to stand properly. Surgeons suggested spine operation but I didn’t want that, so I took chiropractic treatment. While I was given a treatment window of six months, I was able to walk after two months, which was no less than a miracle.”
What is chiropractic treatment?
As a licensed healthcare professional related to understanding the nerves, chiropractic treatment involves manual therapy–using hands–and includes spinal manipulation. According to the US Department of Health and Human Services, chiropractors perform adjustments to the spine or other parts of the body. This simply means by correcting alignment problems, the patient’s pain is eased, which improves the body’s natural ability to heal itself.
“If there is spinal pain, we treat the imbalances in the joint or muscle rather than looking at exercises or spending an expensive amount on machines or medicines to kill the pain. A modern-day chiropractor does not only treat with hands. We use certain advanced technologies also,” said Dr. Bajaj, who specializes in CT disc herniation. He added that spinal manipulation, manual techniques, and therapy instruments are some of the chiropractic approaches taken by practitioners.
“We are similar to orthopedic surgeons. Our diagnosis, MRI, X-ray, radiology background is similar. The only difference is they would do the surgery when there is a pharma-surgical intervention. We can come in prior to that if it is not quite surgical such as in cases of disc problems or nerve compressions. Orthopedic doctors or physiotherapists might do spinal manipulation, but chiropractors have expertise in specific spinal adjustments,” Dr. Amit Jimmy Nanda, who represents India at the World Federation of Chiropractors, and is the chairman of the Indian Association of Chiropractic Doctors — the only registered association in India that is self-regulating at the moment — said.
Dr. Shiv Bajaj at this clinic in Delhi. (Source: Dr. Shiv Bajaj)“The doctor first scans all your reports to understand the root cause of the issue, and then they examine the elbow, spine, neck, etc., for spinal manipulation,” said Madhav Inder Singh, 45, a Gurgaon-based business professional who met with an accident that caused him a spinal injury 18 years ago. Through his wife Simrit, a Canadian citizen, he was apprised about chiropractic treatment which is considered the “first line of treatment abroad”, and that is when he came in touch with Dr. Nanda. “I underwent treatment for the first 6-8 months in Canada where I was required to go for the sitting thrice initially. It is better than popping pills. I could move my body within the first 6-8 months and that too without any invasive measures. Now, whenever there is even slight pain, I can visit the chiropractor at Gurgaon’s South Point Mall,” said Singh.
How is the treatment done?
Chiropractic treatment involves muscles, bones, joints, and connective tissues such as cartilage, tendons, and ligaments. In layman’s terms, imagine it to be cracking of the knuckles and back, world-ranked tennis player Yuki Bhambri who swears by the treatment, told indianexpress.com, “albeit in a much more professional way”.
During your first visit, the chiropractor will go through the medical history, and then follow it up with a physical examination where they will check for tenderness and tightness, as well as how well the spinal joint moves. “This involves extensive radiology, MRIs, X-rays, CT Scan reports to understand the root cause of the issue which can be mechanical (how the spine moves) or neurological (nerve-related),” explained chiropractor Dr. Nanda, 43, based out of Canada. He added, “The treatment only targets the specific area of the nerve or muscle – where it is adjusted, and 99 percent of the time, the patient feels the difference.”
If you go to a chiropractor complaining of lower back pain, they check the entire spine–neck (cervical spine), mid-back (thoracic spine), and low back (lumbar spine). “It’s important to examine the entire spine because even though it’s just your lower back that hurts, other regions of the spine may be affected,” explained Dr. Nanda.
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Benefits
Taking the instance of how chiropractors are readily available in labor rooms in the USA for checking the newborn’s spine to treat the “dis-functions right at the start”. Dr. Nanda explained how for some patients with symptomatic causes, a sample visit works; some chronic cases may see results in a few months’ time. Early diagnosis and timely treatment help one to get back to their daily life more quickly and organically.
It is known to help with neck and lower back pain, back sprain injuries, sciatica, inflammation, chronic headaches, neurological conditions as well as blood pressure. Dr. Nanda quoted a research article Mahatma Gandhi’s Health Restored by Chiropractic published in The National Chiropractic Journal that documented how in 1942, Mahatma Gandhi could not attend rallies because of high blood pressure. “So, he had a British chiropractor from Calcutta (present-day Kolkata) who moved in with him for three months; and that was the remedy. Then, he was able to go to rallies. Chiropractic treatment has an amazing history. But unfortunately, when the British left so did the educational system,” he mentioned.
Challenges in the field
While physiotherapy and orthopedic fields are known, there is not much awareness about chiropractic treatment. “India has no school teaching chiropractic. Now, a lot of people claim to be chiropractic but very few, in fact, only 14 chiropractors in India are registered with the association are licensed practitioners,” mentioned Dr. Nanda.
Dr. Bajaj said the number of actual practitioners, at any given time in the country, “fluctuates between 7-10”. “Mostly ex-pats or visiting doctors are there. The lack of awareness is because of regulatory issues as a certain number of doctors need to be there before government regulation kicks in. “This makes it challenging. We are right now, self-regulatory as an association. Without regulation, it is difficult to start a college for a proper doctorate. One needs to understand chiropractic is not a certification; it is not a technique, it is a profession,” explained Dr. Bajaj, while differentiating how the study of doctors of chiropractic takes eight long years, unlike physiotherapy that takes four.
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Notably, chiropractic schools are only available in the USA, Australia, France, UK, and Canada, whereas physiotherapy institutes are available across India.
“On international grounds, chiropractors are doctors. So, we have the right to diagnose and treat. We are not therapists. It is completely a new domain for India and a huge opportunity. Close to 400-500 physiotherapists label themselves as chiropractors and there are no regulations. You can’t take any action against them. The public suffers at large,” he rued.
Dr. Nanda has been practicing for 17 years. (Source: Dr. Nanda)Dr. Alison Bale, 54, a British chiropractor who was practicing in Goa shared how the practice was “great” for her until COVID-19 struck. “I came to India in 2007 because I wanted the adventure of working in a new country. It has been a fulfilling experience. I have ceased my practice because of COVID-19 since January 2020, as well as some other pressing personal reasons. As a foreign national, working in a service-oriented sector has its own challenges because it takes at least 3-4 years for people to get to know you,” Dr. Bale, who graduated in chiropractic from the United Kingdom, and is currently taking online classes as a mindfulness teacher, explained.
There are 70,000 chiropractic doctors in the US, as it is the third-largest health profession in the world after general practice and dentistry; Canada with a population of about 33 million people has over 7,000 doctors, while India — with 7-10 licensed chiropractors — is a “stark contrast”. “Licensed chiropractors are easily accessible in the US. You have to really search for one here. I think people have not really picked it up in India because it requires just five minutes of your time and, therefore, is not appreciated. Taking more time for treatment equals better recovery is a wrong perception,” explained Bhambri, adding how he and a lot of other tennis professionals vouch for this treatment for its ability to improve the body’s range of motion (which is necessary as restricted spinal motion or when the spine doesn’t move as well as it should, can cause back pain).
What does the future hold for the practice in India?
“Right now, the plan is to open up three schools — including in Gujarat and Haryana — and start with a full-doctorate program. We are right now working through the legalities. End of 2021, we could possibly have the first batch,” said Dr. Nanda, stating the schools will be operated in association with the American chiropractic school Life Chiropractic College West, San Francisco.
1. Low Back PainLow back pain is one of the most common reasons people seek treatment from a chiropractor. Research on spinal manipulation often focuses on low back pain. Some people with low back pain benefit from going to a chiropractor, according to the National Center for Complementary and Integrative Health. Some research suggested people with low back pain got better relief from going to a chiropractor than from going to their family doctor.
2. Neck PainChiropractors often treat neck pain with neck manipulations. These are also called adjustments. In some cases, these neck adjustments—along with exercises—may work better for neck pain than pain medications. You may want to try a chiropractor if you have had neck pain for a long time that is not due to an injury. This type of neck pain may respond to chiropractic care.
3. Tension HeadachesChiropractic adjustment for your neck may help if you have tension headaches. These are a common type of headache that causes pain in the back of your head and neck. Stress and bad posture can cause tension headaches. A chiropractor might adjust your neck and give you some stretching exercises. The chiropractor might also suggest healthy ways to reduce stress and relieve your headaches, including proper posture and body mechanics.
4. Migraine HeadachesResearch has shown that chiropractic spinal manipulations can decrease migraine frequency, decrease pain, and reduce the need for migraine medication. How this occurs is not known. The authors of the study suggest that chiropractic care reduces overall stress, which may, in turn reduce the effect of migraines. Triggers for migraine headaches may include certain foods. Your chiropractor can also give you advice on nutrition and some changes in your diet to help treat migraines and other types of headaches.
5. WhiplashWhiplash is a type of neck sprain that often results from a car accident. Whiplash causes pain and stiffness in your neck. Pain may be worse when you try to turn your head. You may even feel dizzy or sick to your stomach. Chiropractic adjustment may help. A chiropractor may have you do exercising and stretching at home, too, and show you how to use heat or ice to reduce muscle spasms and swelling.
6. Sacroiliac PainYour sacroiliac (SI) joint is a big joint at the bottom of your spine. SI joint problems cause a different type of low back pain. You may feel this pain in your buttock or the back of your thigh. Chiropractors treat this type of pain with chiropractic adjustment. The chiropractor might also teach you how to avoid straining your SI joint. And, he or she might give you some exercises to strengthen your core muscles, which are the muscles that support this joint.
7. Shoulder PainYou probably think about back and neck pain when you think about chiropractic care. However, a chiropractor might also be able to help you if you have a stiff and painful shoulder. This condition is called frozen shoulder syndrome. People with frozen shoulder may have less pain and more movement after chiropractic care. Your chiropractor will stretch the muscles surrounding your shoulder and show you how to perform more stretches at home.
8. Knee PainMost often, wear and tear on the knee joint causes knee osteoarthritis. This is a very common condition. Chiropractic care might help. Chiropractors sometimes do back adjustments along with knee adjustments. This type of treatment may work better than knee exercises alone. Some people treated with chiropractic adjustment have less pain and better movement after a few weeks of treatment.
